Heart failure & cardiomyopathiesMeta-analysis
Impact of Guideline-Directed Medical Therapy on Systolic Blood Pressure and Cardiovascular Outcomes in Patients with Heart Failure and Low Blood Pressure: A Systematic Review and Meta-Analysis
- Systematic review and meta-analysis of randomised trials
Authors' conclusion
Guideline-directed medical therapy is associated with a negligible decrease in SBP, but can provide similar cardiovascular benefits in both low and non-low SBP HF patients, with no significant interaction with SBP as to hypotension.
Study context
- Population
- Heart failure (HF) patients, by baseline systolic BP (SBP) category (low vs non-low)
- Participants
- 84,782 patients · 20 studies
- Comparison
- Guideline-directed medical therapy (GDMT) vs control, by baseline SBP
- Outcome
- Longitudinal change of SBP due to GDMT, and risks of CV events by SBP category
Pooled result
Change in SBP
Weighted mean difference (WMD)
−2.16
95% CI −2.86 to −1.46
GDMT vs Control
WMD −2.16 (95% CI −2.86 to −1.46)
As reported in the abstract
Further pooled results
SBP change from baseline in treatment group, by baseline SBP subgroup · during follow-up
mmHg
- Low SBP subgroup: SBP increased
- 5.8
- Non-low SBP subgroup: SBP decreased
- 4.0
CV benefits, low vs non-low SBP subgroups
- Similar CV benefits between low and non-low SBP subgroups
- interaction p = 0.318
Safety
Hypotension, low vs non-low SBP subgroups
- Similar risk of hypotension between low and non-low SBP subgroups
- interaction p = 0.903
Original publication
Impact of Guideline-Directed Medical Therapy on Systolic Blood Pressure and Cardiovascular Outcomes in Patients with Heart Failure and Low Blood Pressure: A Systematic Review and Meta-Analysis. Eur J Heart Fail. Published 12 April 2024. doi:10.1002/ejhf.3208
Summarised from the published abstract; every number is checked against it